The phenomenon of strictures of the colon induced by nonsteroidal anti-inflammatory drugs is a newly recognized pathologic entity that has gained little exposure in the surgical literature to date. A further case is reported and the clinical features of this entity are discussed. Most patients present with symptoms suggestive of malignancy, namely anemia, obstructive symptoms, or weight loss. Pathologic changes are characterized by diaphragm-like strictures with submucosal fibrosis. Surgical resection to exclude malignancy and treat symptoms along with cessation of the nonsteroidal anti-inflammatory drug is the treatment of choice.

The predictors of CBD stones are imprecise. Until laparoscopic exploration of CBD becomes widely available, ERCP prior to cholecystectomy will remain popular. The use of stricter selection criteria can reduce the number of negative preoperative ERCP.